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Usefulness of the fluid balance: A randomised controlled trial in neonates


  • Conflict of interest: None to declare. All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare that (i) YvA, PB and JB have support from the Princess Amalia Children's Clinic, Isala Klinieken for the submitted work; (ii) YvA, PB and JB have no relationships with companies that might have an interest in the submitted work in the previous 3 years; (iii) their spouses, partners, or children have no financial relationships that might be relevant to the submitted work; and (iv) YvA, PB and JB have no non-financial interests that may be relevant to the submitted work.
  • Trial registration:, number NCT00962754.

Correspondence: Mrs Jolita Bekhof, Princess Amalia Children's Clinic, Isala Klinieken, Dr van Heesweg 2, PO Box 10400, 8000 GK Zwolle, The Netherlands. Fax: +31 38 4247660; email:



To assess the effects of fluid balance charts in neonates with moderate disease severity on duration of hospitalisation and medical interventions.


Randomised, controlled trial in a neonatal ward in a general teaching hospital in the Netherlands between June 2009 and March 2010.

One hundred seventy neonates with moderate disease severity, requiring continuous monitoring of vital parameters (mean gestational age 36+2 weeks (standard deviation 2+5 days), mean birthweight 2782 g (standard deviation 749 g)) participated. In the control group (n = 86), attending physicians could access all fluid balance data, whilst these data were blacked out in the intervention group (n = 84). Primary outcome was length of hospital stay. Secondary outcomes were percentage weight loss, interventions based on the fluid status, unblinding of fluid balance data and incident reporting.


Length of hospital stay did not differ significantly between the intervention and the control group (median 9 vs. 8 days, with ratio of geometric mean 1.25, 95% confidence interval 0.99 to 1.57; P = 0.06). We found no significant differences in secondary outcomes.


Routinely keeping fluid balances in neonates with moderate disease severity does not affect duration of hospitalisation or medical treatment.